Trending Articles
-
Minerva anestesiologica · Jul 2022
Randomized Controlled TrialBuprenorphine versus dexamethasone as perineural adjuvants in femoral and adductor canal nerve blocks for total knee arthroplasty: a randomized, non-inferiority clinical trial.
Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. ⋯ Buprenorphine is in the present trial inferior to dexamethasone by less than the established non-inferiority limit when used as perineural adjuvant in femoral nerve or adductor canal blocks in total knee arthroplasty analgesia. So, it could be considered an alternative in patients where dexamethasone is contraindicated, such as diabetics.
-
Hypocalcemia is a well-known complication of total thyroidectomy. Patients who have previously undergone gastric bypass surgery may be at increased risk of hypocalcemia due to gastrointestinal malabsorption, secondary hyperparathyroidism, and an underlying vitamin D deficiency. We present the case of a 58-year-old woman who underwent a total thyroidectomy for the follicular variant of papillary thyroid carcinoma. ⋯ Her serum calcium levels remained normal on this regimen after hospital discharge despite persistent hypoparathyroidism. Bariatric surgery patients who undergo thyroid surgery require aggressive supplementation to maintain normal serum calcium levels. Preoperative supplementation with calcium and vitamin D is strongly recommended.
-
Annals of intensive care · Dec 2016
Low cardiac index and stroke volume on admission are associated with poor outcome in critically ill burn patients: a retrospective cohort study.
Impact of early systemic hemodynamic alterations and fluid resuscitation on outcome in the modern burn care remains controversial. We investigate the association between acute-phase systemic hemodynamics, timing of fluid resuscitation and outcome in critically ill burn patients. ⋯ Low initial SV and CI were associated with poor outcome in critically ill burn patients. Very early hemodynamic monitoring may in help detecting under-resuscitated patients. Future prospective interventional studies should explore the impact of early goal-directed therapy in these specific patients.
-
The main question to ask himself when preparing to write an article is "why publish a scientific paper?" First of all to publish an own article qualifies his author - or authors - as "scientist". Because the surgery is a mixture of art and knowledge, which coexist and interreact mutually increasing each other, scientific publications are the world where ideas are shared. Secondly, to an academic career is essential to be Author of scientific publications; but also for those who follow an hospital career or simply exercise the surgical profession in other contexts it represents the opportunity to communicate their experience and give a personal contribution to the knowledge of the art. ⋯ For psychological reasons it is difficult for someone to cheer the professional success of a not related fellow, and therefore it is advisable to refrain from this type of publication, which is a waste of time not very profitable, both to the one's reputation and for the likely rejection by the most accredited scientific journals. The publication of a case report must follow the same rules set for a "genuine article", with the difference that in the introduction has to be immediately highlighted the particularity of the experience, possibly framing it in common knowledge. The presentation of the clinical and strategic aspects is the result of a careful reflection on the surgical experience lived, because its exposure has to be very different from an extemporaneous oral presentation, which is by nature open to a free immediate confrontation in oral discussions that follow.
-
Ann Fr Anesth Reanim · Jun 2008
Case Reports[Resuscitation after three hours of cardiac arrest with severe hypothermia following a toxic coma].
We report the case of a 37-year-old woman who survived from severe hypothermia (rectal temperature: 22 degrees C) and prolonged cardiac arrest with asystole after benzodiazepine and tricyclic antidepressant poisoning. Basic-cardiopulmonary resuscitation and mechanical ventilation was started by a French Mobile Intensive-Care unit. ⋯ The patient was discharged at day 13 without any neurological deficit. The discussion focuses on the benefit of extracorporeal-membrane oxygenation (ECMO) as extracorporeal circulation device through femoral access, the differential diagnosis between death and recoverable cardiac arrest and neuroprotection.